Derm pls Flashcards by Hania Azraa

Spot diagnosis and management

Acne fulminans - hospital admission and oral steroids

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Acne management

Benzyol peroxide
Topical retinoids
Topical Abx
Oral antibiotics - doxycyclne, lymecycline (use erythromycin in pregnancy)
COCP
Oral isotretinoin (pregnanct is contraindication)

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Spot diagnosis and management

Actinic keratosis - premalignant condition due to chronic sun exposure.
Management - sun avoidance, fluorouracil cream (2-3 week course)
Topical diclofenac
Topical imiquimod cream

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Athletes foot

Caused by genus trichophyton
Topical imidazole first line

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Spot diagnosis and management

Refer if BCC is suspected.
Management is surgical removal, curettage, cryotherapy, imiquimod, fluorouracil, radiotherapy

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Features of BCC

Central crater

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Most common type of BCC

Nodular

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Spot diagnosis and management

Bowen’s disease - precancerous dermatosis to SCC.
Scaly red patches.
Management: topical 5-fluorouracil BD for 4 weeks
Cryotherapy
Excision

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Spot diagnosis and management

Bullous pemphigoid - autoimmune condition causing sub-episdermal blistering of the skin - BP180, BO230.

Skin biopsy - immunoflouresence shows IgG and C3

Refer to dermatology for biopsy and confirmation of diagnosis

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Burns - assessment of extent of burns

Wallace’s rule of nines, lund and browder chart

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Spot diagnosis and management

Cherry haemangioma

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Spot diagnosis and management

Plaque psoriasis - most common form of psoriasis

Silvery white scale - elbows and knees.

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Spot diagnosis and management

Contact dermatitis

Topical steroids treatment

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Spot diagnosis and management

Dermatitis herpetiformis - caused by coeliac’s

Skin biopsy - immunoflorescence shows deposition of IgA

Management - gluten free diet and dapsone

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Spot diagnosis and management

Dermatofibroma - common benign fibroma

Management - reassurance
Removal surgically but recurrence is common

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Spot diagnosis and management

Eczema herpeticum - caused by herpes simplex 1 or 2.
Rapidly progressing painful rash,

Life-threatening in children - admit for IV aciclovir

Spot diagnosis and management

Erysipelas - strep pyogenes.
More superficial and limited version of cellulitis,

Management is flucloxacilin

Spot diagnosis and management

Erythema multiforme

Spot diagnosis and management

Erythema nodosum - usually self resolving
Common in pregnancy

Hyperhydrosis management

Topical aluminum chloride (first-line)
Botulism toxin

Spot diagnosis and management

Impetigo
Localised disease- hydrogen peroxide 1%, topical antibiotic cream
Extensive disease - oral flucloxacillin
School exclusion until the lesions are crusted and healed or 48 hours after antiobiotic treatment

What is Keratoacanthoma?

Benign epithelial tumour

Management of urticaria

Antihistamines - first line
Steroids for severe or resistant episodes

Toxic epidermal necrolysis management

Stop precipitating factor
Supportive care in ICU
IV immunoglobulins

Squamous cell carcinoma treatment

Surgical excision with 4 mm margins if <20 mm in diameter. >20 mm diameter - 6 mm margins.

Poor prognostic factors of SCC

>20 mm in diameter >4mm deep Immunosuppression

Spot diagnosis and management

Shingles. Herpes zoster infection - acute unilateral blistering rash Management: Contaneous until vesicles crusted over Analgesia - paracetamol and NSAIDs (first-line) Antivirals - within 72 hours in most patients

Spot diagnosis and management

Pyoderma gangrenous - inflammatory skin ulceration Found in IBD, rheumatoid, SLE, myeloproliferative, lymphoma, ML, granulomatosis with polyangitis Typically lower limb Management oral steroids

Spot diagnosis and management

Pyogenic granuloma - common in pregnancy Self resolve post partum

Spot diagnosis and management

Rosacea Management - topical brimonidine Topical ivermectin for mild-moderate moderate to severe - topical ivermectin + oral doxy

Spot diagnosis and management

Psoriasis Management - topical steroids

Spot diagnosis and management

Molluscum contagiosum Self limiting, contagious but school exclusion no necessary

Malignant melanoma: prognostic factors

Breslow depth >4mm - 50% 5 year survival rate

Management of severe burns

Early intubation IV fluids in children with burns >10% of total body surface area and adults >15% of total body surface area Urinary catheter inserted Analgesia Escharotomies

How would you determine how much fluid to give someone in the presence of severe burns?

Parkland formula Total body surface area of the burn % x weight x 4 Administer first half in 8 hours

Rosecea - predominant erythemia/flushing minus papules/pustules

Topical brimonidine gel